Emergency contraception Flashcards
Three options for EC
LevonElle
EllaOne
Copper IUD
What is LevonElle? How does it work? Time frame and dose given
Levonorgestrel - progesterone only pill - 1.5mg STAT
- works within 72 hours/3 days
- stops ovulation and implantation
When do you double the dose of LevonElle?
If the person is over 70kg or has a BMI of 26 of over
What is the time frame in which a second UPSI can occur, after which it is not necessary to take another LevonElle?
12 hours
What advice would you give someone after taking LevonElle?
Short term advice
- Can make you feel sick, dizzy, tired, breast tenderness.
- Vomit within 3hrs - repeat dose
- You might get light bleeding but this is just from the pill, it is NOT a period so NOT A GOOD TIME to have more UPSI
Period advice
- Most women have normal periods next time round, but it might be earlier or later than usual.
- Late period or lighter bleeding >5-7 day - do a pregnancy test
Long term contraception
- can take COCP immediately
- or IUD
Example of the follow up advice you would give someone who is going to take LevonElle
This is a pill you can take up to 3 days or 72 hours after the unprotected sexual intercourse.
Let me talk you through what you might experience when you take the LevonElle pill. Common side effects include feeling sick, dizzy, tired, having breast tenderness or diarrhoea. Now if you do vomit within 3 hours of taking the pill, we would recommend that you take another pill. Another side effect of this pill is that you may experience some light bleeding which may look like a period. However it is not a period, so please be cautious during this time - if you having sex again and don’t want to get pregnant, we would recommend using contraception.
Does that make sense? Any questions?
On the topic of periods, your next period might be slightly earlier or later than usual. If you find that it is later by 5-7 days, please do a pregnancy test. The chances of getting pregnant are small, but there is still a slight risk. There is also a risk of something called an ectopic pregnancy, where the baby grows outside of the womb instead of in the womb, but this is also quite rare.
Any questions?
Finally I would like to talk to you about long term contraception. The pill that we will give you won’t provide contraception going forward, so would you like to think about or talk about long term options? One option is the COCP and another is the IUD. I can give you leaflets about both, and you are welcome to book an appointment with us to talk you through it.
What is EllaOne? How does it work? Time frame and dose given
EllaOne = Morning After Pill = Ulipristal acetate = Selective progesterone receptor modulator
Taken within 120hrs or 5 days of UPSI
30mg STAT dose, even if over 70kg or over 26 BMI
Contraindications for ulipristal acetate
Severe asthma needing steroids
Use of Levonorgesterol
Enzyme inducing drugs
If on antacids or drugs raising gastric pH Pregnancy
Liver dysfucntion - be cautious
Hereditary galactose intolerance
Lapp lactase deficiency
Glucose-galactose malabsoprtion
What advice would you give someone taking EllaOne?
Short term advice
- Can make you feel sick, dizzy, tired, breast tenderness, diarrhoea, abdo pain, mood disturbances, pelvic pain.
- Vomit within 3hrs - repeat dose
- You might get light bleeding but this is just from the pill, it is NOT a period so NOT A GOOD TIME to have more UPSI
Period advice
- Most women have normal periods next time round, but it might be earlier or later than usual.
- Late period or lighter bleeding >7 day - do a pregnancy test
-Pregnancy and ectopic unlikely but if you experience lower abdo pain - go to A and E immediately
Long term contraception
- can take COCP AFTER FIVE DAYS, use barrier for 5 days
- or IUD
When can someone take the COCP after EllaOne and after LevonElle?
After LevonElle - immediately
After EllaOne - only after 5 days, use barrier methods in the mean time
How long should people avoid breastfeeding for if taking EllaOne?
Avoid for 36 hours
When would you offer the IUD if someone has taken EllaOne?
If they are vomiting persistently for 24 hours or have diarrhoea for 24 hours.
If IUD not suitable, what would you prescribe in someone who is vomiting after taking LevonElle or EllaOne?
If IUD not suitable, prescribe anti-emetic like domperidone.
